Organization
BARNELL DIALYSIS, LLC
Active
Other names
Pine Park Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE&CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
3333 BAYSHORE BLVD, PASADENA, TX 77504-1952
(713) 943-1463
(713) 943-1481
Mailing address
5200 VIRGINIA WAY, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
110257
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
360177501
—
TX
Enumeration date
01/11/2014
Last updated
03/19/2025
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